Vasc Spec Int.  2019 Dec;35(4):245-250. 10.5758/vsi.2019.35.4.245.

Rupture, Breakdown, and Pulmonary Artery Embolism of a Balloon Catheter Tip during Percutaneous Transluminal Angioplasty of Arteriovenous Fistula

Affiliations
  • 1Department of Radiology, Research Institute for Clinical Medicine, Biomedical Research Institute, Chonbuk National University Hospital, Chonbuk National University Medical School, Jeonju, Korea.
  • 2Department of Surgery, Research Institute for Clinical Medicine, Biomedical Research Institute, Chonbuk National University Hospital, Chonbuk National University Medical School, Jeonju, Korea. h2p@jbnu.ac.kr
  • 3Department of Thoracic and Cardiovascular Surgery, Research Institute for Clinical Medicine, Biomedical Research Institute, Chonbuk National University Hospital, Chonbuk National University Medical School, Jeonju, Korea.

Abstract

Percutaneous transluminal angioplasty is a well-known treatment for arteriovenous fistula stenosis. Balloon rupture during endovascular procedures is a rare but possible complication. The bursting balloon itself does not cause a serious problem, but it can occasionally cause entrapment, especially in case of breakdown of the balloon catheter tip. Here, we present four cases of balloon rupture during angioplasty in the hemodialysis circuit. In three cases, the ruptured balloon catheter was removed by cutdown of access conduit, while in one case, tip of ruptured balloon catheter was migrated into the pulmonary artery and was removed surgically. The operator must attempt to reduce the risk of balloon rupture by gradually expanding the balloons under bursting pressure. If the balloon bursts, it should not be removed excessively and attempt should be made to remove it using endovascular techniques. Surgical removal is considered after careful evaluation of the condition of the balloon and vessel.

Keyword

Angioplasty; Breakdown; Arteriovenous fistula

MeSH Terms

Angioplasty*
Arteriovenous Fistula*
Catheters*
Constriction, Pathologic
Embolism*
Endovascular Procedures
Pulmonary Artery*
Renal Dialysis
Rupture*
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